Kazuro Kotoda

Hepatic Lymphatics as Opacified by Percutaneous Intrahepatic Injection of Contrast Medium: Analysis of Hepatic Lymphograms in 125 Cases

Hepatic lymph vessels were opacified in 125 patients with various hepatobiliary diseases during percutaneous transhepatic cholangiography or portography. Contrast medium deposited in the parenchyma flowed relatively quickly in winding channels, usually toward the hepatic hilus. No correlation was demonstrated between the locus of the intraparenchymal deposit and the direction of the flow. Contrast medium also opacified the lymphatics near the hepatic hilus and abdominal aorta. Neither jaundice nor liver disorder were prerequisite for the visualization of the hepatic lymphatics. The intrahepatic injection of contrast medium provides a safe and useful method for the study of hepatic lymph and its pathways.

Influence of experimental hepatic disorder on plasma cholesterol esters (I)

Serum Triglycerides level in hepatic disease showed high in serum hepatit is and obstructive jaundice, relatively high level in viral hepatitis, and relatively low level in liver cirrhosis. In the course of hepatic disease, Triglycerides showed markedly relat ionship wi th liver functions, and especially S-GOT, S-GPT, bilirubin became normal or marked reduction in many cases of triglycerides reduced patients. But we noticed that, in the triglycerides increased cases though GOT, GPT became normal level, the other liver functions especially bilirubin, T. T. T. and A.P. was not improved or conversedly worsed in many patients.

Serum alkaline phosphatase activity in hepatitis and liver cirrhosis-pathophysiological observation on cholestatic hepatitis

Normal and l iver impaired ra t wi th CCh received oral admin i s t ra t ion of antibiotics, i .e. 250 mg/kg/day of St reptomycin and Neomycin for 3 days, or the animals were fed wi th low protein diet for 7 days. Af ter t rea tments , the in tes t ina l bac te r ia was isolated. The n u m b e r of intestinal bac ter ia was calculated by Honmas method, amino acid decarboxylase act ivi ty to arginine and tyrosine of the in tes t ina l flora was es t imated by W a r b u r g manomet r i c method. Amine format ion of the bac te r ia in the cul ture media was determined by the method of Asatoor and Kerr. The fol lowing resul t s were obtained. 1. Number of in tes t ina l microorganism was increased by l iver impai rment , and i t was depleted dy admin is t ra t ion of ant ibiot ics to the animal. E. coli was mos t suscept ible to the antibiotics. The low protein diet also repressed an increase of the in tes t ina l flora by CCh treatment. 2. Arginine decarboxylase act ivi ty was depressed by l iver impa i rmen t and it had a tendency to diminish the act ivi ty by ant ib io t ics adminis t ra t ion to bo th normal and CC14 t reated rat . No apparent difference of the act ivi ty by prote in content in the d ie t to the r a t was observed. 3. Tyrosine decarboxylase act ivi ty was markedly accelerated by hepat ic insufficiency and i t was suppressed by admin is t ra t ion of ant ibiot ics or low prote in diet. 4. Amine content in the cul ture media produced by the bac te r ia f rom liver injured ra t was increased, and this increase was suppressed by ant ibiot ics admin is t ra t ion to the animals . Content of prote in in the r a t die t was not influenced to the amine fo rmat ion of the flora.

Studies on the hepatic circulation (I): retrograde porotgraphy

In t rahepat ic aneurysm is an uncommon lesion which is very ra re ly diagnosed preoperatively and only a smal l number of cases have been succesfully treated. A 34-years-old male admitted in our hospital because of bleeding gas t r ic ulcer, and gas t ro je junos tomy was performed on 15. March, 1966. The bleeding was pointed out rup tured a r te ry on the bot tom of the ulcer by histologic examinat ion. After this operat ion serum hepati t is was developed and SGT elevated to 260 u., SGPT was 420 unit . For the purpose of making accurate diagnosis needle biopsy of liver was done under control ing by laparoscopy, and no serious bleeding was noted on liver surface. However following this procedure severe r igh t upper quodrant pain occured and vigorous t a r ry stool wi th hematoemesis came out continiously dur ing several weeks. Then selective cel iacography was performed by Seldinger s method and the X-ray film revealed two round aneurysm in the area of lobus quadora tus of the liver, which had small flngr top size and belong to the 3rd b ranch of hepatic ar tery. On the next day, par t ia l hepatectomy was performed and no more aneurysm was found by direct hepatic a r te r iography dur ing surgery. Now, pa t ien t has no hematoemesis or t a r ry stool af ter hepateetomy and has been very well. Numerous factor have been implicated in the etiology of this disease, bu t in our case needle biopsy tha t has been performed on severe stageof serum hepat i t i s was chief role of making this aneurysm.